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Archive » 2014 » 2 » | Kirurgija » Archive » Medical field » Fields » Surgery »

Laparoscopic Repair of Inguinal Hernia –Transabdominal Preperitoneal Approach; Our Experience

 
Abstract:

This post is also available in: enEnglish slSlovenščina (Slovenian)

BACKGROUNDS. Laparoscopic inguinal hernia repair is still rarely used in Slovenia. In the European Hernia Society guidelines, the use of the laparoscopic transabdominal preperitoneal technique is recommended for the active part of the population (based on the socioeconomic aspect) and for recurrent as well as bilateral inguinal hernias. METHODS. From 2007 to 2012, 48 patients with inguinal hernias were treated for inguinal hernias with the transabdominal preperitoneal approach. The data were collected retrospectively. We routinely use three troacars, a 30° optic and ProTack™ fixating system. Several different mashes were used from the beginning and the ProTack™ system was used for the peritoneal closure. During the last year, we modified our technique and a running Vicryl suture is used for peritoneal closure. RESULTS. In our group, all patients were male, with a median age of 47.79 years (range 15–78 years). All the scheduled operations were completed laparoscopically. The mean duration of a unilateral inguinal hernia repair was 53.6 minutes, 48.6 for recurrent hernia and 76.7 minutes for bilateral hernia (58.4% of hernias were unilateral, 29.2% recurrent and 12.4% bilateral). The average operation time was gradually reduced. In the last year, the average operating time was again longer, due to the fact that the running suture was used for peritoneal closure. The average duration of hospital stay was 1.5 days. Mortality was 0%. Two patients presented with postoperative seroma and one patient had postoperative neuralgia. We had one recurrence six months after surgery (2.08%). CONCLUSIONS. In our group of patients, we did not have any cases requiring conversion to open technique. We had no major intraoperative complications. The average hospital stay was the same as for the patients operated with the Lichtenstein technique. Postoperatively, we did not observe any major complications. The number of recurrences in our group is comparable with European data. According to our limited experience, we believe that transabdominal preperitoneal approach is a safe and efficient method and we expect better results in the future due to the experience we have gained and the adjustments of the technique.

Authors:
Jordan Taja, Mušič Mark

Keywords:
inguinal hernia, transabdominal preperitoneal approach, hernia repair, laparoscopic surgery, Lichtenstein

Cite as:
Med Razgl. 2014; 53 (1): 163–9.
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